As populations in Asia and the Pacific rapidly age, with one in four people expected to be over 60 by 2050, the region is becoming one of the oldest in the world. This demographic shift also means a rising number of people will be living and working with disabilities.

Yet, disability remains a largely overlooked issue in health systems—despite its growing urgency.

Ensuring universal health coverage in Asia and the Pacific is not possible without including people with disabilities. This means going beyond simply improving physical access. It requires rethinking systems, policies, and attitudes. It requires including people with disabilities in system and policy design, and in the health workforce.

Despite growing recognition of the need for disability inclusion, several persistent challenges continue to limit progress toward equitable health.

For many people with disabilities, health care remains physically and financially out of reach. Facilities are often too far, transportation options are limited, and the cost is high. Even when transportation is available, safety and discrimination concerns can still discourage its use. The accumulation of these factors leaves many people, particularly vulnerable populations, excluded from even basic care.

Barriers are not always physical. Many people with disabilities encounter inaccessible equipment, and sometimes, attitudes that discriminate or result in unsafe healthcare. Additionally, health and disability services are often managed by different entities, resulting in fragmented care, unclear roles and accountability, which leads to weakened continuity of care and service.

Without robust, disability-disaggregated data, it is challenging to identify who is left behind and why. This prevents effective monitoring, evaluation, and the design of programs, services and policies.

Even when services are available, quality and consistency remain a question. These challenges are further perpetuated by the lack of well-equipped healthcare professionals to provide disability-informed care.

For many people with disabilities, health care remains physically and financially out of reach.

To address these issues, the following actions are needed:

Embed disability inclusion and co-designing into the health agenda: Integrate disability inclusion as a core component of national and regional policy. This should also involve the participation of people with disabilities during the design phase, viewing them as active partners and not solely as beneficiaries. Their participation ensures the services and supports reflect the real and unique needs of their community.

Strengthen community-based and local health systems: Community-based care is a powerful tool to connect people to care for their community. It not only ensures continuity of care, but also builds local abilities and promotes social inclusion. As seen in India, since the ratification of the UN Convention on the Rights of Persons with Disabilities, integration into national health programs has gained momentum.

Invest in workforce development and professional training: Inclusive care begins with frontline caregivers. Equipping healthcare professionals with the know-how and skills to respond to diverse needs, and offer quality support and compassionate care is mandatory. Training on person-centered care, particularly for people with disabilities, should be an integral part of professional education to ensure it adapts to the evolving needs of this group. Mongolia has seen promising results in promoting accessibility in primary healthcare by upskilling doctors.

Disability inclusion is not just a goal, it is a shared responsibility and a necessary step toward equitable and resilient health systems across Asia and the Pacific. All stakeholders—governments, civil society, healthcare providers, and communities—must actively engage in and support disability inclusion.

People with disabilities should be at the center of these efforts in shaping the policies and programs that affect their lives.

This blog post was based in part on discussions during the "Investing in Actions Addressing Disability" seminar during ADB's 1st INSPIRE Health Forum : Inclusive, Sustainable, Prosperous and Resilient Health Systems in Asia and the Pacific. Raymond John S. Naguit and Maria Celine Santos contributed.